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Trial registered on ANZCTR
Registration number
ACTRN12614000782639
Ethics application status
Approved
Date submitted
14/07/2014
Date registered
21/07/2014
Date last updated
4/12/2019
Date data sharing statement initially provided
4/12/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of Fampyra on visual function following previous optic neuritis.
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Scientific title
A Phase IV double blind placebo controlled cross-over study on the effects of Fampyridine on low contrast visual acuity in patients with previous demyelinating optic neuritis.
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Secondary ID [1]
284937
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Nil
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Universal Trial Number (UTN)
U1111-1159-0154
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Optic Neuritis
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Condition category
Condition code
Neurological
292733
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0
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Multiple sclerosis
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Eye
292830
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0
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Diseases / disorders of the eye
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Fampridine 10mg po BD for 4 weeks.
Adherence will be monitored by a pill log and drug tablet return.
A phone call review at 2 weeks will assess the pill log, adverse events to try and improve adherence.
A 2 week wash out period will occur between two arms of a cross-over trial design.
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Intervention code [1]
289766
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Treatment: Drugs
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Comparator / control treatment
Placebo controlled - 1 microcellulose tablet po BD for 4 weeks
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Binocular low contrast visual acuity
- low contrast Sloan letter chart (100%, 5%, 1.25%, 0.06%)
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Assessment method [1]
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Timepoint [1]
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Baseline, and at 4 weeks of study drug.
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Secondary outcome [1]
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P100 latency of qualifying affected eye
- Visual evoked potential obtained measurement completed as per ISCEV standards
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Assessment method [1]
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Timepoint [1]
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Baseline, and at 4 weeks of study drug
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Secondary outcome [2]
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Visual quality of life measure by NEI-VFQ25
- total and subscores.
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Assessment method [2]
309263
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Timepoint [2]
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Baseline and following 4 weeks of study drug
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Secondary outcome [3]
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Perimetric mean deviation of visual fields
- calculated by Humphries Visual Field testing.
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Assessment method [3]
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Timepoint [3]
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Baseline and at 4 weeks of study drug
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Secondary outcome [4]
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Monocular low contrast visual acuity as an experimental outcome
- low constrast Sloan letter charts (100%, 5%, 1.25%, 0.06%)
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Assessment method [4]
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Timepoint [4]
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Baseline and following 4 weeks of study drug
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Eligibility
Key inclusion criteria
Previous symptomatic monocular optic neuritis in setting of Multiple Sclerosis or other demyelinating optic neuritis
Reduction in binocular low contrast visual acuity as measured by Sloan Letter low contrast visual acuity chart (at least 7 letters on contrast level 0.6%)
Residual prolonged P100 latencies on visual evoked potentials >110ms
Reduction in visual quality of life measure, NEI- VFQ 25:
(total score <90 and one subscale score <90; or 3 subscale scores < 90)
Age 18 y or over
Able to give informed consent
Eligible for Fampyra (fampridine) treatment according to the local label
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
History of seizures
Renal impairment (CrCl <50ml/min or eGFR <59 ml/min)
Pregnancy or Breast Feeding
High contrast monocular visual acuity in the affected eye worse than 6/15 (20/50).
Visual impairment in the eye not affected by the qualifying episode.
Optic neuritis within the 6 months prior to randomization. Patients who develop optic neuritis during the course of the study will be excluded from analysis.
Other visual diseases affecting measures – glaucoma, cataracts
Clinical diagnosis of Neuromyelitis Optica
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A sample size of 16 has 80% power to detect a difference of 3 letters in low contrast visual acuity, which is well below the difference between those with MS and healthy controls of 7 letters and we expect represents a clinically important difference.
For our most important secondary outcome, visual evoked potentials, a sample size of 16 has 80% power to detect a paired difference of 5 msec using the larger SD. We will recruit 20 subjects for this study to allow for drop outs during the course of the study.
Simple data descriptions including paired t-tests for the outcome at each visit as well as change from baseline will be used. The primary analysis for continuous variables will be mixed linear models with the baseline measurement as a continuous co-variate and a random effect for participant to account for the cross-over design.
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data analysis is complete
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Reason for early stopping/withdrawal
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
1/08/2014
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Actual
5/12/2015
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Date of last participant enrolment
Anticipated
31/10/2014
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Actual
20/06/2017
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Date of last data collection
Anticipated
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Actual
20/06/2017
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Sample size
Target
20
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Accrual to date
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Final
15
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Recruitment outside Australia
Country [1]
6203
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New Zealand
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State/province [1]
6203
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Wellington
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Biogen Idec Australia Pty Ltd
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Address [1]
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Suite 1, Level 5, 123 Epping Road
North Ryde
NSW
Australia 2113
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Jennifer Taylor
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Address
Neurology Department
Clinical Measurement Unit
Wellington Hospital
Riddiford Street
PO Box 7902
Wellington 6242
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Country
New Zealand
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Secondary sponsor category [1]
288250
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Individual
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Name [1]
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Dr Gareth Parry
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Address [1]
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Neurology Department
Clinical Measurement Unit
Wellington Hospital
Riddiford Street
PO Box 7902
Wellington 6242
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Country [1]
288250
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health No 1 The Terrace PO Box 5013 Wellington 6145
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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31/07/2014
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Approval date [1]
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04/09/2014
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Ethics approval number [1]
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14/CEN/122
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Summary
Brief summary
Optic neuritis is a condition where optic nerve inflammation occurs leading to reduced visual function. It is a common presenting episode of multiple sclerosis, and many patients with multiple sclerosis will have had optic neuritis through the course of their disease. Whilst high contrast visual acuity generally recovers well months following the event, there is evidence of under-recognised visual dysfunction in patients with previous optic neuritis, as well as Multiple Sclerosis, using other measures such as low contrast visual acuity and vision related quality of life measures. Fampyra is a potassium channel blocker which as been proven to improve walking speed in Multiple Sclerosis, as a symptomatic treatment. It's benefit is thought to be due to restoration of nerve conduction in unmyelinated nerves. Our plan is to test whether Fampyra can provide benefits on visual function in those patients with a previous episode of optic neuritis, and measures of visual dysfunction on screening investigations. The study will employ a randomised cross over placebo controlled study design, with 20 patients undergoing assessments around a 2 stage study, with Drug A and then Drug B given for a four week period, with a 2 week washout period. Visual assessments will be undertaken at baseline, and at 4 weeks on the study drug to look for change in function. Assessments will include low contrast visual acuity, vision related quality of life measure (NEI-VFQ25), visual evoked potentials (a electrophysiological marker of optic nerve conduction), and visual field testing.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Jennifer Taylor
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Address
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Neurology Department,
Clinical Measurement Unit,
Wellington Hospital,
PO Box 7902,
Wellington 6242
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Country
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New Zealand
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Phone
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+64 21 211 3867
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Fax
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+64 4 806 0072
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Email
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[email protected]
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Contact person for public queries
Name
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Jennifer Taylor
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Address
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Neurology Department,
Clinical Measurement Unit,
Wellington Hospital,
PO Box 7902,
Wellington 6242
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Country
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New Zealand
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Phone
49775
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+64 21 211 3867
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
49776
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Jennifer Taylor
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Address
49776
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Neurology Department,
Clinical Measurement Unit,
Wellington Hospital,
PO Box 7902,
Wellington 6242
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Country
49776
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New Zealand
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Phone
49776
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+64 21 211 3867
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Fax
49776
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Email
49776
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Anonymised data of results
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When will data be available (start and end dates)?
1/12/2019 - 06/6/2020
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Available to whom?
MS and optic neuritis researchers
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Available for what types of analyses?
For discussion
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How or where can data be obtained?
Contact primary investigator
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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